title: Effects of compulsory rural vocational training for Australian general practitioners: a qualitative study.
abstract: BACKGROUND
  Increasing the recruitment of doctors, including general practitioners (GPs), to rural areas is recognised as a health priority internationally. Australian GP trainees (registrars) complete a mandatory minimum of 6 months training in a rural area. The rationale for this includes the expectation of increased likelihood of a future choice of rural practice location.
  
  
  METHODS
  A qualitative study employing semistructured in-depth interviews and a modified grounded methodology. Participants were 15 registrars from an Australian GP postgraduate training program.
  
  
  RESULTS
  Though generally a rewarding clinical learning experience, negative aspects of the rural placement included the disruption to personal lives of rural relocation and the stresses involved in higher levels of clinical responsibility. These stressors could undermine rather than enhance clinical confidence. Anxiety and depression were accompaniments for some registrars. Intention to practice rurally was little influenced by this compulsory placement.
  
  
  CONCLUSIONS
  Findings of positive effects on rural practice destination in studies of medical undergraduates should not be generalised to GP registrars. The positive clinical learning experience of most registrars in rural terms must be balanced with the social dislocation involved in rural relocation and the adverse effects of the rural experience, for some registrars, on professional confidence and psychological well being.
authors.affiliation: General Practice Training Valley to Coast, Newbolds Building, Gavey Street, Mayfield, NSW 2304, Australia.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Bayley
authors.forename: Parker J
authors.initials: PJ
authors.lastname: Magin
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Sweatman
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Regan
mesh_terms: D004503:Education, Medical, Graduate; D005260:Female; D058005:General Practitioners / Q000193:education*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D037141:Mandatory Programs; D009517:New South Wales; D015397:Program Evaluation; D012424:Rural Population